Shoulder Flashcards
Presentation of adhesive capsulitis
Often non-traumatic
Acute phase, middle phase, final phase
Often self-resolves in 2-3 years
Acute phase of adhesive capsulitis
Moderate to severe pain that limits ROM
Middle phase of acute capsulitis
Less pain but describes lifting arm and internal/external rotation is severely restricted
Final phase of adhesive capsulitis
Slowly increased ROM
3 stages of adhesive capsulitis s
Freezing, frozen, thaw
Cause of adhesive capsulitis
Unknown
Slight increase in diabetes, hyperthyroidism, COPD
Inflammation leads to fibrosis
Epidemiology/risk factors for adhesive capsulitis
45-60 yoa, 70% female, prolonged immobility, previous injury, previous surgery, diabetes, hypothyroidism
Adhesive capsulitis diagnosis
Based on history, loss of shoulder ROM, Mazion shoulder test
Adhesive capsulitis treatment
Most cases improve within 2 years without treatment, treatment depends on phase of condition
Treatment of phase 1 adhesive capsulitis
Avoid aggressive adjustments, focus on mobilization, isometric exercises, codman’s exercises, sleep on unaffected side
Treatment of phase 2/3 adhesive capsulitis
Adjust and mobilize shoulder, codmans exercises, isometric exercises, stretching
Medical co-management of adhesive capsulitis
Arthroscopic surgery, pain killers, corticosteroid injection, manipulation under anesthesia
Impingement syndrome anatomy
Rotator cuff muscle tendons pass through a narrow space between the acromion process of the scapula and the head of the humerus
Impingement syndrome causes
Anything which causes further narrowing of the space can result in impingement syndrome
-bony structures such as subacromial spurs
-osteoarthritis spurs on the acromioclavicular joint
-variations in the shape of the acromion
Type 1 acromion process variation
Normal—flat
Type 2 acromion process variation
Gently curved
Type 3 acromion process variation
Hooked—will likely cause more issues to soft tissues
Impingement syndrome s/s
Pain, weakness, pain at night sleeping on affected shoulder, limited ROM, painful arc of movement from 60-120 degrees, passive movement is painful
Impingement syndrome diagnosis
History of painful arc, grinding or popping, physical exam, x-ray of shoulder
Co-management of impingement syndrome
Consult (surgical—if conservative methods fail), acupuncture, physical therapy
Treatment of impingement syndrome
Progression from isometrics to isotonic exercises, ice, superior to inferior adjustments of GH joint
Contraindicated adjustments for impingement syndrome
S-I AC joint
Good adjustments for impingement syndrome
I-S adjustments of sternoclavicular joint and GH joint, S-I adjustment of GH joint
